Vitamin D deficiency is a prevalent condition,cutting across all ethnicities and among all age groups,and occurring in about 30%-50% of the population. Besides vitamin D established role in calcium homeostasis,its def...Vitamin D deficiency is a prevalent condition,cutting across all ethnicities and among all age groups,and occurring in about 30%-50% of the population. Besides vitamin D established role in calcium homeostasis,its deficiency is emerging as a new risk factor for coronary artery disease. Notably,clinical investigations have suggested that there is an association between hypovitaminosis D and acute myocardial infarction(AMI). Not only has it been linked to incident AMI,but also to increased morbidity and mortality in this clinical setting. Moreover,vitamin D deficiency seems to predispose to recurrent adverse cardiovascular events,as it is associated with post-infarction complications and cardiac remodeling in patients with AMI. Several mechanisms underlying the association between vitamin D and AMI risk can be involved. Despite these observational and mechanistic data,interventional trials with supplementation of vitamin D are controversial. In this review,we will discuss the evidence on the association between vitamin D deficiency and AMI,in terms of prevalence and prognostic impact,and the possible mechanisms mediating it. Further research in this direction is warranted and it is likely to open up new avenues for reducing the risk of AMI.展开更多
Background: The SpineNav3DTM technology was recently incorporated in the Accuro device for the automatic detection of spinal bone landmarks. The goal of our study was to validate the ability of the Accuro ultrasound s...Background: The SpineNav3DTM technology was recently incorporated in the Accuro device for the automatic detection of spinal bone landmarks. The goal of our study was to validate the ability of the Accuro ultrasound scanner to detect the distance from skin to epidural space by comparing it to the golden standard (the standard ultrasound). The secondary end-point was the inter-rater agreement between an expert anesthesiologist and a novice trainee in determining the epidural space depth with the Accuro device. Methods: 96 consecutive healthy volunteer parturients at term had their lumbar area scanned for the measurements of the depth of the epidural space (recorded in cm) by two anesthesiologists. The expert investigator made the measurements with both the standard ultrasound and the Accuro devices, and the trainee made the measurements with the Accuro device only. Results: There were no differences in the mean depth of the epidural space as measured by the expert or the novice investigator with both the devices (standard ultrasound and Accuro) in both positions (sitting and lateral) at any intervertebral level with a difference less than 0.25 cm. Conclusion: We have demonstrated that this handheld ultrasound system with 3D spine navigation technology can automatically identify the key neuraxial landmarks within ultrasound images of the lumbar spine acquired in the transverse plane and measure the epidural depth with the same accuracy as the standard ultrasounds. We have also demonstrated that the measurements may be rapidly and adequately obtained by a novice who had never previously used ultrasounds.展开更多
文摘Vitamin D deficiency is a prevalent condition,cutting across all ethnicities and among all age groups,and occurring in about 30%-50% of the population. Besides vitamin D established role in calcium homeostasis,its deficiency is emerging as a new risk factor for coronary artery disease. Notably,clinical investigations have suggested that there is an association between hypovitaminosis D and acute myocardial infarction(AMI). Not only has it been linked to incident AMI,but also to increased morbidity and mortality in this clinical setting. Moreover,vitamin D deficiency seems to predispose to recurrent adverse cardiovascular events,as it is associated with post-infarction complications and cardiac remodeling in patients with AMI. Several mechanisms underlying the association between vitamin D and AMI risk can be involved. Despite these observational and mechanistic data,interventional trials with supplementation of vitamin D are controversial. In this review,we will discuss the evidence on the association between vitamin D deficiency and AMI,in terms of prevalence and prognostic impact,and the possible mechanisms mediating it. Further research in this direction is warranted and it is likely to open up new avenues for reducing the risk of AMI.
文摘Background: The SpineNav3DTM technology was recently incorporated in the Accuro device for the automatic detection of spinal bone landmarks. The goal of our study was to validate the ability of the Accuro ultrasound scanner to detect the distance from skin to epidural space by comparing it to the golden standard (the standard ultrasound). The secondary end-point was the inter-rater agreement between an expert anesthesiologist and a novice trainee in determining the epidural space depth with the Accuro device. Methods: 96 consecutive healthy volunteer parturients at term had their lumbar area scanned for the measurements of the depth of the epidural space (recorded in cm) by two anesthesiologists. The expert investigator made the measurements with both the standard ultrasound and the Accuro devices, and the trainee made the measurements with the Accuro device only. Results: There were no differences in the mean depth of the epidural space as measured by the expert or the novice investigator with both the devices (standard ultrasound and Accuro) in both positions (sitting and lateral) at any intervertebral level with a difference less than 0.25 cm. Conclusion: We have demonstrated that this handheld ultrasound system with 3D spine navigation technology can automatically identify the key neuraxial landmarks within ultrasound images of the lumbar spine acquired in the transverse plane and measure the epidural depth with the same accuracy as the standard ultrasounds. We have also demonstrated that the measurements may be rapidly and adequately obtained by a novice who had never previously used ultrasounds.
